Frequency and characteristics of disease flares in ankylosing spondylitis

Cooksey, R., Brophy, S., Gravenor, M.B., Brooks, C.J., Burrows, C.L. and Siebert, S. (2010) Frequency and characteristics of disease flares in ankylosing spondylitis. Rheumatology, 49(5), pp. 929-932. (doi: 10.1093/rheumatology/kep435)

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Abstract

<b>Objective.</b> To examine the characteristics and frequency of disease flares in a cohort of people with AS.<p></p> <b>Methods.</b> A prospective data set from a randomized controlled trial (RCT) of a probiotic treatment/placebo was utilized to examine disease flares in 134 people with AS. Disease flares were defined as either minor/localized flares (pain/swelling localized to one area with fatigue and stiffness) or major/generalized flares (generalized pain, hot burning joints, muscle spasm, fever, sweating, extreme fatigue and stiffness).<p></p> <b>Results.</b> One hundred and thirty-four people were followed up for 1216 person follow-up weeks and there were 71.4 flares per 100 person-weeks. Of these, 12 were major/generalized flares and 59.4 were minor/localized flares. People who experienced at least one major/generalized flare during the study period had worse disease during flare-free periods in terms of disease activity, impaired function, self-reported night pain and iritis compared with those who did not experience any major/generalized flares during the study. Major/generalized flares lasted for an average of 2.4 weeks (s.d. 2.7), and were preceded by and followed by a minor/localized flare in 92% (55/60) of cases.<p></p> <b>Conclusion.</b> Seventy per cent of people with AS felt they had a flare in any given week. Those who experienced major/generalized flares appear to have more severe and active disease even during periods when not in flare, compared with those who do not experience major/generalized flares. These results have implications for the timing of assessments prior to starting anti-TNF therapy and suggest that the presence of major flares may be helpful in identifying patients with severe disease.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Siebert, Professor Stefan
Authors: Cooksey, R., Brophy, S., Gravenor, M.B., Brooks, C.J., Burrows, C.L., and Siebert, S.
College/School:College of Medical Veterinary and Life Sciences > School of Infection & Immunity
Journal Name:Rheumatology
ISSN:1462-0324
ISSN (Online):1462-0332
Published Online:01 February 2010

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